Jackson, John Claude
Jackson, John Claude is an sole proprietor health care provider with primary practice located at 410 E Cherokee St , Wagoner OK 74467-4708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, John Claude can be contacted via phone (918) 485-5591.Contact Information
Primary practice address
410 E Cherokee St
Wagoner OK 74467-4708
Phone: (918) 485-5591
Fax: (918) 485-5758
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1672 | Oklahoma |
Profile Details
| NPI number | 1669433546 |
|---|---|
| LBN Legal business name | Jackson, John Claude |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Mar 23rd, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669433546 | NPPES |
| Oklahoma | MEDICAID | 100141080C | |
| Oklahoma | MEDICAID | 100141080E |
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